captioning sponsored by macneil/lehrer productions >> ifill: president obama set the stage for yet another fight over taxes, calling for a one year extension of bush era cuts for the middle class. mitt romney supports lowering rates for all americans, permanently. good evening, i'm gwen ifill. >> woodruff: and i'm judy woodruff. on the "newshour" tonight, we examine the candidates' dueling plans and their moves to appeal to voters this november. >> ifill: then, we debate the wisdom of allowing iran to acquire nuclear bombs. >> woodruff: betty ann bowser looks at a new health care trend: concierge medicine offering specialized care for those who can afford it. >> what happens if somebody gets sick at 2:00 in the morning? >> it happens and they wake me up. you know what? i ask for that.

>> ifill: hari sreenivasan interviews npr's howard berkes about the rise in black lung disease, that's sickening thousands of coal miners. >> woodruff: and we close with a conversation with journalist david maraniss. his new book traces president obama's family history and explores how his early years shaped his future. >> that's what fascinated me in the beginning, sort of the unlikeliness of this character coming from so many different places and weaving it together in someone who became president. >> ifill: that's all ahead on tonight's "newshour." major funding for the pbs newshour has been provided by: and with the ongoing support of these institutions and foundations. and... this program was made possible by the corporation for

public broadcasting. and by contributions to your pbs station from viewers like you. thank you. >> ifill: tax politics returned to center stage in washington today, as president obama called for extending middle class tax cuts and mitt romney said the white house plan doesn't go nearly far enough. ( applause ) the white house east room was the backdrop for a presidential pivot today: moving away from talk of job loss to promises of tax cuts. >> the republicans say they don't want to raise taxes on the middle class. i don't want to raise taxes on the middle class. so we should all agree to extend the tax cuts for the middle class. let's agree to do what we agree on, right? ( applause ) that's what compromise is all about.

let's not hold the vast majority of americans and our entire economy hostage while we debate the merits of another tax cut for the wealthy. >> ifill: the president is reviving his proposal to extend existing tax cuts at the end of the year, but only for those who earn $250,000 or less annually. allowing those cuts to expire, he said, would be a big blow to working families and a drag on the entire economy. the one-year tax cut extension the president proposes would cost $150 billion. allowing the cuts to expire for those who earn more would generate $850 billion over the next decade. but $1.2 trillion in automatic spending cuts are already scheduled to begin taking effect early next year. lawmakers agreed to those cuts as part of last year's deal to raise the debt ceiling. the romney campaign today called the president's proposal a political statement that would hurt, rather than help,

taxpayers. romney spokesperson andrea saul said in a statement: other republicans offered a similar critique in advance of the president's remarks. senate republican leader mitch mcconnell told cnn the president's plan could make a bad problem worse. >> and we have got the fiscal cliff coming at the end of the year. you know, what we ought to be doing is extend the current tax rates for another year with a hard requirement to get through comprehensive tax reform one more time. >> ifill: both campaigns are appealing to middle class pocketbooks at the same time they are adding record sums to their campaign coffers. romney and the republican national committee reported raising $106 million last month, outstripping the president and

the democrats, who pulled in $71 million. outside fundraising groups are raising and spending millions more. all those dollar signs add up to a debate that could easily determine which party wins the white house and the congress this fall. for more on the politics behind the policy, we turn to "newshour" political editor christina bellantoni and stuart rothenberg of the "rothenberg political report." listening to the president just now, christina, i was interested when he talked about the pivot point we just mentioned. he said that the core mission is putting people back to work but also rebuilding an economy where that work pays off. is that when you turn the corner from last week's bad news to try to read a finding this? >> that's exactly what the president is trying to do. he likes this turf being able to talk about what he would do for middle class families because the tax cut issue. this is something he's been talking about for many many years now. his first campaign event in 2007 this was his biggest applause line saying i will get rid of these tax cuts for people who

don't need them. he's refined his language. it's where he wants to be playing and not about unemployment rate. >> ifill: when the president uses terms like stalemate to describe where congress is now -- we've used other words over the years, gridlock, you name it -- is he talking about philosophy or strictly about politics. >> about partisanship and politics. it's about defining the republicans as opposing any progress so that at the end of the day no matter what the job numbers show and the unemployment numbers show he can blame the republicans whether it's president bush or this congress and say they really haven't participated. they haven't helped me get this economy going. >> ifill: right under the surface, it seems or maybe not under the surface, right on the surface is this class war argument. he calls it a fairness argument. does that stick? is that what this was about today? >> i guess we're going to see whether it sticks. historically it hasn't stuck all that well. right now people seem focused on

how is the president doing? how is the economy doing? are we getting jobs? the white house is trying to change the sub. it's a very reasonable strategy. i think it's a bit of an uphill one. but it's not an impossible one. >> ifill: so this who wins that argument? >> a lot polls say it's a popular idea to tax the rich more. right? more americans think that's okay. there's a lot of nuance in the polls as well. one thing that is interesting that polls show that congress is about the most unpopular thing in the country right now. so barack obama likes to campaign against congress. when he's locked in this very tight battle with mitt romney when the two of them are just a few points apart it's much easier to campaign against someone with a 10 or 12% approval rating. >> ifill: he said let's agree on what we agree on. why isn't that reasonable why won't that work? >> nobody wants to take these votes in an election year where they have to accomplish something. it's much easier to put their stamp on. the republicans will come out

with a counterproposal in the house. >> think about what he said, gwen. he said this is my position. it's also the republicans' position. so why can't they compromise with me on this? i think the republicans will say what he wants them to do is cave on tax cuts for all and not compromise. >> ifill: the other thing the republicans seem to be doing is they're about their own definitions right now too. they're talking about the president's zombie economy which the jobless numbers help the poor. >> they bring it back to jobs. and the sense that the economy has not recovered. this is a battle over what the election is about. the democrats want it to be about certain things. the republicans want it just to be about jobs and the new jobs numbers, the employment numbers. >> the democrats want it to be about his elitism and jet skis and off-shore accounts and outsourcing. the republicans want it to be about barack obama's failed presidency. >> right. whether it's more about what

we're talking about, how americans feel about this economy is the big question because it does... there are multiple polls showing a lot of different groups of voters are being affected by negative messaging that's coming overwhel pingly from the obama campaign. it will be coming from all sides. this is a core issue, the economic argument of who is for you, who is for the little guy? barack obama is trying to say that's him. >> does these arguments trickle down to state races and senate competition to battle ground states. >> absolutely. i've already gotten an email today, tom smith a republican senate candidate in pennsylvania says bob casey and the president are on the same page. they want higher taxes. chris shays, a moderate republican when he was in the house now running for the u.s. senate i got an email, there goes the president. higher taxes. republicans believe they can jump on this message. there are parts of the country congressional districts are safe where the democratic message about fairness works well. but republicans think that they always like to talk about taxes

and higher taxes and bigger government. >> the democrats i talked to feel similarly. they like having this argument as well. if we want to have this dpebt over who is going to help the middle class more, we'll talk about that and point to republicans who just want to help the rich. >> ifill: the republicans are all raising money hand over fist. mitt romney raised $4 million. this weekend the president had two campaign fund-raisers today. the president sent out this s.o.s. email or the president's campaign saying help, help, we're going to be beat. which one of these things gained traction or is it a wash? >> there will be plenty of money thrown around. everybody will have enough of it. they'll each raise the temperature by saying this other guy is going to outspend us. we're going to be completely underwater by their big cash. >> i think what happens is you have so much money, so many messages countering one another that voters, particularly swing voters, there's a default to this. republicans support republicans, democrats, democrats. swing voters i'm not sure what

their default is. that's the danger for both parties. >> ifill: maybe it's not how the money is raised but what it is spent on. a conversation for another night. thank you, both. >> sure. thank you. >> woodruff: still to come on the "newshour": a debate over nuclear weapons for iran; patients paying for special attention from doctors; a coal miners' disease on the rise and author david maraniss on president obama's roots. but first, the other news of the day. here's hari sreenivasan. >> sreenivasan: the taliban claimed responsibility today for a roadside bombing that killed six american troops in afghanistan. their armored vehicle hit a bomb planted in wardak province in the east yesterday. insurgents have been using the area as a gateway into kabul. meanwhile, donor nations meeting in tokyo pledged $16 billion in aid for afghanistan. but they urged the afghan government to do more to improve human rights, particularly for women. a power struggle unfolded in egypt today between the newly elected president and the military. president mohammed morsi ordered

the parliament to reconvene, but that move was rejected by the highest court. instead it ruled the military's decision to disband parliament last month was final and binding. the country has been in political turmoil for nearly 17 months, when longtime leader hosni mubarak was overthrown. international envoy kofi annan tried to revive peace efforts in syria today. he met with president bashar al- assad in damascus, where the two agreed on an approach to restore calm. we have a report narrated by alex thomson of "independent television news." >> reporter: homs today and what amateur cameramen there said was sustained shelling yet again. certainly government armor is seen moving and firing on these deserted streets. a couple of hours drive south, and in the capital of damascus kofi annan again raising hopes of peace, recognizing his peace plan on the ground is ignored. >> they reassured me of the government's commitment to the six-point plan which of course we should move ahead to

implement in a much better fashion than has been the situation so far. >> reporter: and a brief public appearance for president bashar al-assad. he was asked to comment on america's role in supporting the opposition here. >> they offered the umbrella and political support to those gangs to create destability or to destabilize syria. >> reporter: and while others, not least kofi annan, describe syria as being at a turning point, the president himself says he's not for turning. >> the president shouldn't run away from challenge and we have a national challenge now in syria. the president shouldn't escape. >> reporter: in this civil war, more than 17,000 people have now been killed. >> sreenivasan: one of syria's key allies-- russia-- announced today it will not sell new weapons to syria anymore. that's at least until the crisis there has stabilized. however, russian officials will continue to keep previous

weapons contracts. international election observers in libya declared the weekend vote a success. nearly 1.8 million libyans went to the polls on saturday in the country's first free national election in 60 years. the vote count is ongoing, with official results expected later this week. preliminary results suggest a strong showing for mahmoud jibril-- the western-educated interim prime minister. fatal flooding in russia over the weekend did not come with adequate warning, the russian emergencies minister admitted today. torrential rains and floodwaters inundated the black sea region early saturday, killing more than 170 people. residents were forced to flee their homes in the middle of the night as up to a foot of rain fell in less than 24 hours. across much of the united states today, people got a little relief from a record setting heat wave. a cold front pushed across the plains states bringing stormy weather and damage, along with cooler conditions to the eastern half of the country. the streak of triple digit temperatures caused the deaths of at least 48 people. cell phone tracking by law enforcment agencies is on the rise based on a report made to

congress by cell phone carriers. carriers handed over information on more than 1.3 million requests last year alone. for more on this i'm joined by eric lichtblau of the "new york times." eric, your report raises a lot of privacy concerns, including ones that the carriers are feeling. help us understand that. >> well, what we found in these reports is that the carriers themselves are rejecting a fair number of demands for records that police and law enforcement agencies are making. these are cases where the carriers say, you know, there's not a true emergency when they demand these records or a court order may not be signed when it's supposed to be signed or they may not have even gone to a judge. these are cases where congressman marky who had asked for this data describes it as a digital drag net that could wrap in lots of unintendedded people into police investigations. >> sreenivasan: are these the modern-day wire taps? >> it's looking that way. the number of wire taps is actually going down while other areas of cell phone surveillance

like g.p.s. locating devices and text message collection and things like that are way, way up. the main reason is is that those other types of things are much, much easier for cops to get than the standard wire tapping which requires court orders. it's pretty time consuming legally. now it's very, very easy for them to get these other types of cell phones surveillance. >> suarez: very briefly, what happens to all that data if i happen to be near a cell phone tower that a law enforcement agency dumped all the data from? >> well, if the police or the d.a. or whomever is asking for a dump of cell phone data within a certain tolerant, they'll get back hundreds or thousands of names of people who are within a certain area at a certain time of day. that goes into a database and becomes part of the investigative file. the problem is that there are very inconsistent standards as to how long that can be retained for. the hope in some departments is it's destroyed as soon as it's

not relevant to the investigation but that certainly doesn't happen at all times. >> sreenivasan: arguments began today in u.s. district court in washington over whether texas can require voters to show photo identification at polling places. the obama administration blocked the law last year saying it was unfair to minority voters. texas then sued the u.s. government citing political motives. the law is one of several recent disputes over the 1965 voting rights act, which prohibits discriminatory voting practices. the supreme court upheld a similar photo i.d. law in indiana in 2009. nearly 50 years after their plane went down, the remains of six airmen who disappeared during the vietnam war were buried at arlington national cemetery today. the remains were buried in a single casket, after being discovered last year by american and laotion search teams. for decades, family members knew only that the plane sent out a "mayday" signal while flying over laos. all six servicemen were given posthumous promotions by the military. on wall street today, stocks slipped in a light day of trading. the dow jones industrial average lost 36 points to close at

12,736. the nasdaq fell more than five points to close above 2,931. the oscar-winning actor ernest borgnine died on sunday of kidney failure in los angeles. borgnine played more than 200 film and t.v. roles, and worked up until the end. he won an academy award in 1955 for his portrayal of a lonely bronx butcher who falls in love in the film "marty." >> i don't want to go to star dust ball room because all that ever happened to me there was girls made me feel like i was a bug. i got feelings, you know. i had enough pain. no, thanks, ma. >> marty. no. i'm going to stay home tonight and watch the hit parade. >> you're going to die without a son. >> so, i'll die without a son. marty, put on the blue suit, huh. >> blue suit, great suit. i'm just a fat, ugly manjoo you're not ugly. >> i'm ugly, i'm ugly, i'm ugly. ma, leave me alone. >> sreenivasan: ernest borgnine was 95 years old.

those are some of the day's major stories. now, back to judy. >> woodruff: and we turn to iran. european union and iranian representatives will meet in two weeks to explore re-starting the stalled nuclear talks. this comes as some here in the u.s. argue iran should be allowed to acquire nuclear weapons. last week, ballistic missiles shot through the skies above the deserts of iran. though part of a planned military exercise, iranian officials said the launch came with a message to the united states and israel-- do not attack our nuclear facilities. then came reports that the u.s. had ramped up its naval presence in the persian gulf. both developments followed another set of failed nuclear talks among iran and officials from the u.s., china, russia, france, britain and germany. iranian officials have long insisted their nuclear work is only for peaceful purposes. but the u.s. and israel, which

have their own extensive arsenal of nuclear weapons, have led efforts against a nuclear-armed iran. a book just out, written by two journalists, claims that israel has gone so far as to launch cyber attacks and kill iranian scientists in an effort to slow down any nuclear advancements. in march, president obama reinforced his pledge to stop iran's nuclear capabilities in a speech to the american-israel political action committee. >> iran's leaders should understand that i do not have a policy of containment; i have a policy to prevent iran from obtaining a nuclear weapon. >> woodruff: last month, israeli prime minister benjamin netanyahu reiterated his stance when meeting with russian president vladimir putin. >> ( translated ): we agreed that nuclear weapons in the hands of the iranians would create a grave danger, not only a grave danger to israel but also a grave danger to the

entire region and the whole world. >> woodruff: but a new essay in "foreign affairs" magazine titled "why iran should get the bomb" sees a much different scenario playing out. veteran scholar kenneth waltz writes: meanwhile, tough international economic sanctions, including an oil embargo by the european union this month, have led to rising inflation for iran. now two views on whether a nuclear armed iran makes the middle east a safer place. john mearsheimer is a professor at the university of chicago, a west point graduate and former air force officer, he's written extensively on strategic issues. dov zakheim served in the pentagon during the

administrations of george w. bush and ronald reagan. he's now a senior advisor at the center for strategic and international studies. gentlemen, thank you both for being with us. john mearsheimer, i'm going to start with you. this did start with the article in foreign affairs magazine. you don't go as far as that author does in arguing that a nuclear-armed iran would be a net positive. but you do agree with him that it would bring stability to the region. why? >> i think there's no question that a nuclear-armed iran would bring stability to the region because nuclear weapons are weapons of peace. they're weapons of deterrence. they have hardly any offensive capability at all. and if iran had a nuclear deterrent, there's no way that the united states or israel, for that matter, would be threatening to attack iran now. in the same way that if saddam had had nuclear weapons in 2003,

the united states would not have invaded iraq. and if libya had nuclear weapons in 2011, the united states would not have gone to war against libya. so i think that if you had a middle east where other states besides israel -- and this of course includes iran, had a nuclear deterrent, it would be a more peaceful region. but the problem is that there is always some small possibility that there will be nuclear use. and the most likely scenario is what's oftentimes referred to as inadvertent escalatio this is where you have a conventional war that starts off with no intention of turning into a nuclear war, but inadvertently escalates to the nuclear level. you can hypothesize all sorts of situations, for example, where a conventional war between india and pakistan which both have nuclear weapons escalates from the conventional to the nuclear

level. of course, the same logic applies to the middle east. there's only a small, a very small possibility that that would happen. but that small possibility is enough to make me very wary of the idea of iran acquiring nuclear weapons. >> woodruff: okay. so you're saying you buy the idea it adds stability. you do have the very serious caveat about the idea of conventional warfare getting out of control. but let's just focus on this idea that it would bring stability. you heard john mearsheimer say that they are inherently peaceful weapons. they are a deterrent as they were during the cold war. what about that argument? >> inherently peaceful is hard to imagine in terms of nuclear weapons. they ended world war ii after all. but the problem is sort of magnified by what john mearsheimer just said. if iran acquires these weapons -- that's assuming that the israelis don't attack ahead of time or someone else doesn't

attack -- if they get these weapons, that is definitely going to cause at least three or four more countries in the region to acquire those weapons as well, probably saudi arabia, probably the united arab emirates. possibly turkey, possibly egypt. >> woodruff: you mean because they would want to... >> either because they will be afraid of iranian nuclear blackmail or they will be afraid that iran could transfer technology to those who might attack them in some way. i mean, after all look at what pakistan did with its nuclear technology. look at what north korea did with its technology. >> woodruff: you're saying it will set off... >> it will set off a chain of nuclear weapon states. what you'll then have is essentially from europe's borders with russia all the way to china, nuclear states cheek by jobl, all it takes is one mistake. >> woodruff: john mearsheimer, why wouldn't that happen which would clearly not be a more

stable situation? >> well, it's possible there will be some proliferation. it wouldn't bet against the fact that maybe turkey or saudi arabia would acquire nuclear weapons but people have been predicting widespread proliferation for decades now. it's never happened. but i think the two reasons that it wouldn't happen. one is that the iranians would not be able to blackmail anybody in the neighborhood with their nuclear weapons. we've created this myth in this country over the past few years in talking about iran that any country that acquires nuclear weapons can blackmail other countries or use those nuclear weapons for offensive purposes. we have a lot of theory and a huge amount of empirical evidence, 67 years now, that show that no country with nuclear weapons can blackmail another country as long as somebody is protecting that country or it has its own nuclear weapons. this leads to the second reason. the united states is going to extend its nuke loor umbrella over saudi arabia and over turkey the way it extended it over germany and japan during

the cold war. we will make it perfectly clear to the iranians that they cannot blackmail anybody. so there will be no great incentive for turkey or for saudi arabia to acquire nuclear weapons. but even if they do acquire nuclear weapons, what are they going to do with them. >> woodruff: i'll turn that back with you and then i want to follow up. >> sure. the problem is of course it's not likely that anybody is going to use them. but if there's any chance at all -- any chance that somebody might -- the more countries that have these weapons, the likelier it becomes that someone might use them. in a crisis most people think that nuclear weapons may well ultimately be used in an indo-pak war. they did go to war after they tested nuclear weapons. one of the things walt argues, by the way, is that countries with nuclear weapons don't go to war with each other. even china and the soviet union went to war. >> woodruff: let me ask about

another fundamental point. it is not iran that would be creating instability but it's the existing instability created by israel. you read what he wrote. it's this longstanding... the fact that israel alone has had nuclear weapons has created an imbalance and that as long as that's the case, there will be an imbalance. >> yes. in fact what he said is that it's caused instability, israel has, for the last 40 years. therefore, israel's nuke already weapons caused the iran-iraq wars of the 1980s. it caused saddam hussein's invasion of kuwait in 1990. it's caused the arab spring and all the instability that has taken place there. of course it's the cause of the syrian civil as well. look at all the things the israeli nuclear weapons have caused. >> woodruff: quick response, mr. mearsheimer. >> i don't think that israel has caused hardly any of those problems. there's no debate with doug on

that particular point. but the fact is that if iran had nuclear weapons, it's extremely unlikely that you would have another iran-iraq war. if iran had nuclear weapons israel and the united states would not be threatening iran today. this is the basic point. because nuclear weapons or weapons of mass destruction and they would lead to possible annihilation of any two countries that got into a nuclear war, it therefore makes war extremely unlikely. or therefore unlikely when nuclear weapons are present. >> that's not the case. india and pakistan went to war after they both had nuclear weapons. >> woodruff: we hear you both. i didn't say it was impossible. >> woodruff: very, very tough subject. we thank you both. online we have an interview with the scholar we spoke of whose foreign policy article argues that a nuclear iran would offer more stability, not less.

>> ifill: it's a common refrain. patience say it's getting harder to see a doctor. when they do, they feel pressed for time. but for a price, a small but growing number of clinics offer a more boutique relationship. a model of care that raises questions about equality and access. newshour health correspondent bete and bowser reports. >> up. open. >> reporter: it's 6:00 on a recent tuesday night in cady, texas, and time for a little tai chi. >> turn the palm down. press down. >> reporter: this is just one of the unusual tngs dr. ramon solis does for his patients. have you ever made a house call. >> yes, i have. reporter: have you ever gone to the emergency room to meet a patient? >> i do that all the time. you have that copy for me. put it on my desk. >> reporter: this doctor runs a unique kind of practice. with the help of a consulting firm called m.d.v.i.p.

>> and tomorrow, we're ready for the first patient in the morning. >> yes, sir. at 8:30. >> reporter: for about $1500 a year patients are allowed to join solis's practice in return for more face time with the doctor. it's called concierge medicine. what happens if somebody gets sick at 2:00 in the morning. >> it happens and they make me up. you know what? i asked for that. >> reporter: six months ago, solis signed on with the florida-based network of about 500 primary care physicians. >> and how are you doing on the lipitor right now? >> doing great. reporter: the consulting firm helped him convert his 21-year-old practice of 3,000 patients to just 400. that means most people can get same-day appointments that last 30 minutes or longer. mark morrison is the company's president of marketing and innovation. >> our doctors are primary care doctors and doctors who have

become frustrated with what has become conveyer belt medicine. they're seeing 30, 35 patients a day, spending less and less time with their patients. >> reporter: linda and richard henning have been patients of dr. solis for years. when they found out he was converting to a concierge practice that would cost them $150 a month, they were concerned. they are both retired and on medicare. >> being on fixed income, basically, we're thinking, how can we afford this? but, you know, our health is important because you have nothing if you don't have your health. you're gone. >> reporter: linda gets emotional talking about this. because just a few months signing up solis discovered richard had lymphoma. overnight he needed tests, scans and appointments with cancer specialists which solis arranged. >> dr. solis went the extra mile to makes those phone calls to get us in immediately so the time from concept of having cancer has really moved along so

fast its just kept me on a fast track. >> with the reduced number of patients that i can see i am able to return those calls and those labs in a shorter period of time than the typical doctor. >> reporter: solis has also taught richard some meditation techniques to manage his pain. there are no firm numbers but its estimated there are between 1,000 and 5,000 concierge medical practices in the country today. health policy researchers think the concept is getting more popular. some of the doctors accept insurance. others take cash only to avoid having to deal with the bureaucracy of insurance companies. most charge big bucks for membership, anywhere from $5,000 to $20,000 a year. but m.d.v.i.p. saw a market for practices that charge a lot less about $150 a month per patient.

they limit practices to no more than 600 people, but take insurance. murrison says 92% of patients renew their memberships each year and part of the reason is the emphasis on preventive medicine which saves money by keeping people in good health. >> our hospitalization rates are 72% to 79% lower than when you look at non m.d.v.i.p. members. when you look at the medicare population it is 72% less. so there is a real demonstration that this approach to care works. >> reporter: but dr. pauline rosenau of the university of texas health science center in houston questions claims like that. she says concierge practices may be cherry picking the healthiest patients and skewing the numbers.

plus, she worries about the lack of state or federal regulation to protect consumers. >> i think they may be selling this to doctors just like they are selling it to patients and in both cases buyer beware, keep your eyes open, read the fine print before you get involved. i'm skeptical where medical i worry that were basing it on emotion and advertising rather than the facts. >> reporter: m.d.v.i.p. says its research shows people trust its business model. in five years, membership has tripled to 180,000. the average age of patients is 55. >> this is steve kelly. i'm a patient of dr. burpeaus. i was trying to get in for a follow up to my back problem i was having. mmm, yeah. i can be there in about an hour. >> reporter: 51-year old houston energy analyst steve kelly has

no reservations about the $1,500 a year he's spending. >> i definitely think its worth it. i'm 51 years old. i want to stay healthy. i have two young kids and that's top priority in my life right now so anything i can do to remain that way i'm all for it. >> reporter: five years ago when houston internist john burpeau became an m.d.v.i.p. doctor he was on his way to burnout. he was tired of shortchanging patients with eight minute office visits. >> i think people are used to the old way and they think doctors are the way they used to be. doctors like marcus welby they just don't exist anymore. they've been driven out business. because if you take your time and spend time with the patient financially it doesn't work. you can't run a business like that. it works out to be about $4.25 per patient per day. it's affordable. they have to choose to pick it, and they may give up something else for it.

>> reporter: texas has more uninsured people than any state in the nation and that fact prompts health policy analysts like rosenau to question what happens if this concept grows more popular. >> concierge seems so unjust because its making more care available to people who are willing to pay more. it's elitist in the sense that our system have an equity problem to begin with. so many people don't have health insurance. here in houston it's 33%. >> i'm not here to fix the system but what i'm here to do is be part of the solution. and part of the solution is to work on preventative measures so i think that it is in america we have freedom of choice and we have options. and me in a small community of katy, texas, i'm trying to do my part for my community. >> reporter: m.d.v.i.p. believes its brand of concierge medicine like dr. solis' practice here in katy, texas has great growth potential, especially as baby boomers age. if the idea continues to catch

on, they contend, it will also become more affordable for average americans. >> woodruff: next, a new investigation finds a resurgence of a deadly disease in coal mining country. again, hari sreenivasan. >> sreenivasan: more than four decades ago congress set a goal of eradicating black lung disease by passing a law that limited miners' exposure to coal dust. but a joint investigation by npr and the center for public integrity found many miners are still exposed to too much dust leading to a doubling of black lung rates in just a decade. the disease, which can be accompanied by coughing, congestion and difficulty with breathing is debilitating and irreversible. more than 10,000 miners died from it nationwide between 1995 and 2004. the analysis shows many cases in appalachia, a region that includes parts of virginia, kentucky and west virginia.

in west virginia alone, more than 2,000 miners died over a decade. howard berkes of npr was one of the lead reporters on this story. he joins me now from salt lake city. >> it's good to be with you. sreenivasan: folks who haven't heard of or thought about black lung disease, paint us a picture of what it's like to live with it. you were able to speak with people. >> we spent some time with a number of miners who are suffering black lung. it's a horrific way to die. these miners know that that's what they're doing. they're dying. they're slowly losing the ability to breathe. simple tasks like mowing the lawn or one miner we spoke talked about how he can't even hold his two-year-old grandson for more than a few moments, become impossible with black lung. it just gets worse and worse. you can't fix it. there's no treating it.

eventually some miners will end up making a choice between eating and breathing because they can't do both at the same time. some are afraid to fall asleep because, while sleeping, they can't muster the strength to get that breath down. one physician we spoke with talked about it as if it's like taking a screw and slowly tightening it in your throat day after day, year after year. you just lose the ability to breathe. >> sreenivasan: so the big question is, why is it on the rise? >> there are a number of reasons for that. or possible reasons. one is that coal miners are working many more hours now than they used to. the average coal miner is working 600 more hours a year than 30 years ago. the coal seams are thinner now especially in appalachia and in virginia, west virginia, and kentucky. the best seams have been mined

out. and in those seams are threads of rock, of quarts, again especially in that region in appalachia. that qurts contains silica. so when the mining machines grind up the coal and rock with it, they're creating a combination of coal dust and silica. that's a particularly volatile combination. the other thing that's occurred was the law that was passed to protect miners from black lung and from the dust that causes black lung was never really seriously enforced. it was filled with loopholes from the very beginning that enabled mining companies to basically game the system. there's plenty of evidence that we found that there were signs over the years that miners were being exposed to much more coal dust than they were supposed to

be, that the measurement taking by mining companies were not accurate. there were even criminal cases over the years in that regard. so it's a combination of the conditions underground creating more dust, more exposure for miners in terms of the hours they work and a system that has really failed to protect them as congress promised in 1969 when it passed a law that was supposed to protect them from black lung. >> sreenivasan: your reporting indicates discrepancies between when federal inspectors decide to measure the coal dust in the mines versus when the companies report it themselves. how does that happen? >> well, that happens in part because in the system which is partially dependent on self policing by mining companies a federal mine inspector goes into a mine and takes a measurement for coal dust and finds there's a violation, that there's too much coal dust. the mining company then has the opportunity to take five of its own samples of coal dust and then average them. right off the bat just the averaging could lower the

reading. if the averaging is below the standard, the limit, the safe limit for coal dust, then the violation is erased. what we found is that there were more than 50,000 coal dust... valid coal dust samples taken that were above the federal limit but only 2400 violations were issued. we don't know exactly what happened with each of those cases, but it suggests that there were thousands of coal miners in those cases who were exposed to excessive coal dust but the system that is easily gained by mining companies was such that those overexposures did not result in violations issued to those companies. >> sreenivasan: you also point out that more than $45 billion has been paid out in compensation by the companies and the government. isn't there a strong financial incentive for the comp notices to make sure that their workers are safe? >> you'd think so. you would think that that kind of bill and the company share of

that alone, i believe, is -- i'm thinking off the top of my head -- it's many billions of dollars. so this is costing them a lot of money as well as the government. you would think that that would be a disincentive but everything that you do in a coal mine to limit the exposure to coal miners, to mining dust, involves diminishing production perhaps, slowing down the mining machine or moving miners around so they're not exposed as much. and these are things that, you know, on a day-to-day basis could cost a coal company money. we've been through a boom period in coal mining. things have slow down in the last few months. but this has been a boom period. production is up. three fold what it was in 1970. it was up five fold in the year 2000. and that's part of the reason that there may be an increase...

that's one of the reasons that there might be an increase in black lung as well. >> sreenivasan: thanks so much for your time. >> thank you. pressure appreciate it. >> ifill: you can find the full npr story and see a chart showing black lung cases by year on our website. >> woodruff: finally tonight, a new book chronicles president obama's family roots and early years. its author-- pulitzer prize winning journalist david maraniss-- won accolades for his biography of former president bill clinton. i sat down with him recently to talk about his latest endeavor-- a close study of the current president. "barack obama, the story," takes readers to kansas, kenya, hawaii, indonesia, los angeles, new york, and chicago, ending as mr. obama heads to harvard law school. david maraniss joins us now. thank you for being with us. >> thank you, jude he a great to

be here. >> woodruff: you didn't just dash this book off. you went all over the world, went through reems of documents, interviewed how those people. how is this different than preparing for the biography of president clinton? >> that was centered in arkansas which is, you know, another place of someone coming out of nowhere. but to tell this story of barack obama, it really is a global story in so many ways. that's what fascinated me in the beginning. sort of the unlikeliness of this character coming from so many different places and weaving it together into someone who became president. >> woodruff: you were saying you decided to write it on the night of the election. you had been thinking about it, but the night he became president... >> it overwhelmd me that night. before that, i have to confess that over the years before that, i had been a little bit dispirited by the modern american political culture and was not sure that i wanted to throw myself back into that with a biography of a sitting president. but the story in itself became so powerful, i wanted to write

it. >> woodruff: there's so much in here about his ancestors. you open with a story about his great grandmother ruth in kansas, stories about his great great great grandfathers in kenya going back to the 1800s. why were those generations so important to telling his story? >> well, i think they're important to telling "a" story and his story is the culmination of it. we tend to look at anything that's about a sitting president or a modern politician as all having to be about him. in fact, it was the larger story that brought me into it in the first place. but i think that in this case, you can see so much about the president from his past. you know, when you go back into kenya, you see that for several generations, obamas were considered outsiders, just because they came from a different village than where they ended up. also you see in the history of the obamas that it wasn't muslims what affected them in any way.

although the grandfather did convert to islam but at every step in the rise of the obamas you see it was evangelical christians from america who made the rise possible. i thought that was fascinating as a way of explaining the unwitting consequences of history. >> woodruff: i guess it's what, 150 pages in before you talk about his parents. his parents meeting each other in a classroom at the university of hawaii. but so much of the book, david maraniss, is about his search for himself. for his identity. of course. and a lot of that is race. but that's not the whole thing. is it? >> no, it's not. his story is sort of a classic odyssey, an arc towards home. he starts really without a sense of home because he never knew his father. and his mother, as loving as she was and as much as she inculcated her philosophy of life into him, was also not therfor large stretches of his adolescence and teen-aged years. so you see him not only trying to figure himself out as a

bi-racial kid from hawaii, but also trying to find his place personally in the world. it takes him from the island of hawaii to los angeles to new york and finally he finds himself personally in chicago on the south side. so michelle robinson, who is not even in this book, is kind of the magnet you see drawing him all the way along. >> woodruff: you also write about there's this recurring theme of avoiding life's traps. even when he was a young child. >> well, that's part of being a bi-racial kid, i think, is trying to figure out how to negotiate different worlds and not get trapped in some way. you look at his life and you see the trap of being born on an island further from any land mass than any place in the world except easter island. you see the trap of being bi-racial and trying to figure out the different racial subtleties and not so subtle parts of being that in america today. of being defined by society as black and trying to figure that

out and find his his own way to an african-american life. the trap of possibly getting struck in chicago politics with all of this that can be dangerous. all along the way you see him trying to avoid the traps. i think that helps explain his presidency too. that's so much a part of his character and personality that there are times in his presidency where even his supporters think what is he doing? why is he moving so slowly on something? usually because he's calculating ahead trying to figure out where the trap is. >> woodruff: one of the things in here you is you point out at a number of points throughout the book what he wrote in his own memoir dreams of my father were different from the facts that you uncovered and went digging and asking a lot of questions. how did you ultimately explain that. you talked to the president. >> i did talk to the president about that. he had read the introduction to my book before we did our interview. i wanted him to understand what i had found and where i had gone. it was an interesting

conversation. he said, david, this is a really interesting introduction but you call my book fiction. >> i said i call it literature. there's a difference between serious rigorous factual biography and a memoir. when he began his memoir the original title on his proposal was journeys in black and white. the entire book is shaped through the lens of race. he distorts some characters, compressn some, makes some composites with the goal of trying to make different points about the perspectives on race. that's where that comes from. >> what do you say to those critics who say he changed the facts in order to fit a narrative that he wanted to write about himself? >> my perspective on his memoir is that it's a fascinating look inside of his head. it accurately reflects his sort of... how he dealt with the

issues race. but it's not to be judged as a serious biographical history of his life. that's the way i lookate at it. each person can determine for themselves how much leeway you give someone who is writing a memoir. for me it got me inside the head. so when i found something that didn't jibe with the way he presented it in the memoir, it was not that i was trying to catch him on all of these things. i was just trying to get the history right which is different from memoir. >> woodruff: you talk about the light that this sheds to some extent on his presidency. what did you learn about him? i mean, you learned so many things about him. but that would help people, voters who look at him, who try to siez up the kind of leader he is. >> you know, i can do some of that by comparing him with president clinton, the other person i've studied. essentially barack obama did come out of dysfunction, did have a lot of contradictions to work out in his life. he spent ten years of his life,

really the last third of my book reveals this in letters and journals and so much else, really trying to resolve those contradictions, dealing with them seriously in terms of sociology and race and spirituality, almost in every respect. he did a pretty good job of that. he workd harder at it than most anybody else i've ever studied. he came out of that. it really made him what i would call, in quotes, an integrated personality. that got him to the white house. that sort of self-confidence that he had after he found himself. it would also get him in trouble in the white house because he's thinking, well, if i can resolve these contradictions, why can't congress or the cup? he wasn't as prepared in transactional politics as bill clinton was. he came out of dysfunction, just plowing forward. every move. forgiving himself every day. learning how to survive so well. that got him to the white house and got him in trouble in the white house. then he's such a great survivor he got out of trouble. he see the two personality

reaching the same goal in different ways. >> woodruff: 571 pages before you get to the footnotes. he's 27 years old. he's on headed off to harvard law school. you're thinking about a sequel. >> yes, i am. i think by the time he leaves for harvard he's figured things out. he's found his home in chicago. he's studied power for three years on the south side of chicago and understood that he needed electoral power to get where he wanted to go. >> woodruff: why did you stop there in this book? >> because the next book will be all about his political life. this one is the preparation for it. >> woodruff: david maraniss, the book is "barack obama: the story." thank you very much. >> thank you, >> woodruff: on our website animated graphic you can watch the personal footage maraniss shot as he reported in kenya and see more photos of president obama's family tree. tomorrow, we interview author david brody about his new book: "the teavangelicals: the inside story of how the evangelicals and the tea party are taking back america." >> ifill: again, the major developments of the day:

president obama called for a one-year extension of the bush- era tax cuts for the middle class. republicans said it's not enough and the taliban claimed responsibility for a roadside bombing that killed six american troops in afghanistan. we come back to the politics of tax cuts online. hari explains. >> sreenivasan: that's the subject of this week's political checklist. find that on the rundown. and the new nation of south sudan celebrates its one-year birthday today. read about the challenges for the fledgling country on our world page. all that and more is on our website: newshour.pbs.org. gwen? >> ifill: and that's the "newshour" for tonight. on tuesday, we'll look at one man's mission to live forever. i'm gwen ifill >> woodruff: and i'm judy woodruff. we'll see you online and again here tomorrow evening. thank you and good night. major funding for the pbs newshour has been provided by: and the william and flora hewlett foundation, working to

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